Topics to be covered for patients commencing a new antiretroviral regimen
Explanation of HAART
- how HAART works
- patient-specific rationale for starting HAART now, which takes account of the patient's own beliefs about treatment
- goals of HAART
- role of CD4 and viral load testing
- how to monitor HAART
Adherence
- what is adherence
- why it is important
- how drug resistance occurs
- the relationship between adherence and resistance, and treatment failure
- the impact of resistance on future options
- target adherence levels
- what to do if doses are missed, delayed, or vomited
- what to do if stopping therapy
Psychosocial Assessment
- assess motivation, beliefs and attitudes towards medication and adherence
- assessment of behavioural skills necessary for adherence (goal-setting, time-tabling, assertiveness/communication, problem-solving, etc.)
- assessment of behavioural determinants of adherence (daily routine, e.g. eating, sleeping and working patterns; recreational activities; familial/social relationships and responsibilities; travel plans, etc.)
- assessment of social factors relevant to adherence (relationship status, accommodation, financial resources, etc.)
- assessment of psychological disorders (depression, anxiety, etc.)
Medication History
- prescription medicines
- non-prescription (over-the-counter) medicines
- herbal, traditional medicines
- recreational drug and alcohol use
- previous allergies or intolerances, adherence difficulties and strategies
- swallowing difficulties, i.e. can you take a pill or are liquids preferred?
